Liver cancer

Alt. names: Hepatocellular carcinoma. The liver will function normally with only a small portion of it in working order.

Liver cancer can be a primary cancer (starts in the liver) or a secondary cancer (starts in another part of the body and spreads to the liver).

Primary liver cancers

Primary liver cancer is one of the less common cancers in Victoria with about 170 people diagnosed each year. It is more common in men and people aged over 60 years. Most primary liver cancers are called hepatocellular carcinoma, as they start in liver cells called hepatocytes. Others start in a bile duct and are called cholangiocarcinoma.

In the western world, most people who develop primary liver cancer also have cirrhosis of the liver. This is scarring of the liver which is due to a variety of causes including heavy alcohol drinking over a long period of time. However, only a small proportion of people who have cirrhosis of the liver develop primary liver cancer. Infection with hepatitis B, C or D can also increase the risk of developing cirrhosis and, later, primary liver cancer.

Secondary liver cancers

Secondary liver cancer is the most common liver cancer in the western world. A secondary liver cancer is a cancer that starts somewhere else in the body and spreads (metastasises) to the liver. Most cancers can spread to the liver but the common ones are breast, stomach and bowel cancers. These liver cancers are named after the primary cancer for example, breast cancer that has spread to the liver is called metastatic breast cancer. Sometimes, the liver cancer is discovered first, which leads to the diagnosis of the primary cancer.

Symptoms

Liver cancer usually has no symptoms in the early stages. Symptoms can include:

Pain in the upper right side of the abdomen

Fever

Yellowing of the skin and eyes (jaundice)

Nausea

Weakness

Weight loss

Loss of appetite

Swelling of the abdomen.

Diagnosis methods

Liver cancer is usually diagnosed with a number of different tests, which may include:

Blood tests – to check your general health and to check for a chemical (AFP), which is usually found in increased levels in people with a certain type of primary liver cancer.

Ultrasound– a picture of the liver is taken using sound waves.

CT scan – a specialised x-ray taken from many different angles to build a three-dimensional picture of the body.

Magnetic resonance imaging (MRI) – similar to a CT scan but uses magnetism instead of x-rays to build a picture of the body.

Liver biopsy – a small piece of liver tissue is removed with a needle and examined for cancer cells.

Laparoscopy – a small cut in the lower abdomen allows a thin mini-telescope (laparoscope) to be inserted to look at the liver and take a sample of the liver tissue. If the tests show you have secondary liver cancer (and you did not know that you had a primary cancer), you may need further tests to find out where the primary cancer is.

Treatment options

Treatment for liver cancer will depend on whether it is a primary or secondary cancer. Treatment options may include:

Surgery – to remove the cancer and as much damaged tissue as possible. This is the main treatment for primary liver cancer. It is only useful for secondary liver cancer if the cancer cells only affect one part of the liver.

Chemotherapy – either tablets or injections of anti-cancer drugs. Sometimes they are injected directly into the artery that feeds the tumour in the liver (hepatic arterial infusion). It is the main treatment for secondary liver cancer and sometimes used for primary liver cancer.

Radiotherapy – x-rays are used to target and kill cancer cells. It may help in treating some types of primary liver cancers and may be used to relieve symptoms of pain and discomfort from secondary liver cancer.